Endoscopic surgical clip applier and clip applying systems

ABSTRACT

An endoscopic surgical clip applier ( 10 ) includes a handle assembly ( 100 ) configured to releasably engage at least two different endoscopic assemblies ( 200,300 ). The handle assembly ( 100 ) is configured to transition from a non-ratcheting use condition to a ratcheting use condition when an endoscopic assembly ( 200,300 ) configured for ratcheting use is engaged with the handle assembly ( 100 ). The handle assembly ( 100 ) is maintained in the non-ratcheting use condition when an endoscopic assembly ( 200,300 ) configured for non-ratcheting use is engaged with the handle assembly ( 100 ). Endoscopic assemblies ( 200,300 ) for use with the handle assembly are also provided.

BACKGROUND Technical Field

The present disclosure relates to surgical clip appliers and clipapplying systems. More particularly, the present disclosure relates toendoscopic surgical clip appliers having handle assemblies configuredfor use with various different endoscopic assemblies, and systemsincorporating the same.

Description of Related Art

Endoscopic surgical clip appliers are known in the art and are used fora number of distinct and useful surgical procedures. In the case of alaparoscopic surgical procedure, access to the interior of an abdomen isachieved through narrow tubes or cannulas inserted through a smallentrance incision in the skin. Minimally invasive procedures performedelsewhere in the body are often generally referred to as endoscopicprocedures.

Endoscopic surgical clip appliers having various sizes (e.g.,diameters), that are configured to apply a variety of diverse surgicalclips, are also known in the art, and are capable of applying a singleor multiple surgical clips during an entry to the body cavity. Suchsurgical clips are typically fabricated from a biocompatible materialand are usually compressed over a vessel. Once applied to the vessel,the compressed surgical clip terminates the flow of fluid therethrough.

During endoscopic or laparoscopic procedures it may be desirable and/ornecessary to use different size surgical clips or different configuredsurgical clips depending on the underlying tissue or vessels to beligated. In order to reduce overall costs of an endoscopic surgical clipapplier, it is desirable for a single endoscopic surgical clip appliercapable of receiving and firing different size surgical clips as needed.

Accordingly, a need exists for endoscopic surgical clip appliers andsystems that include handle assemblies configured for use with variousdifferent endoscopic assemblies having different clips loaded thereinand/or configured for performing various different surgical tasks.

SUMMARY

As detailed herein and shown in the drawing figures, as is traditionalwhen referring to relative positioning on a surgical instrument, theterm “proximal” refers to the end of the apparatus or component thereofwhich is closer to the user and the term “distal” refers to the end ofthe apparatus or component thereof which is further away from the user.Further, to the extent consistent, any or all of the aspects andfeatures detailed herein may be used in conjunction with any or all ofthe other aspects and features detailed herein.

Provided in accordance with aspects of the present disclosure is handleassembly of a surgical clip applier configured to releasably engage atleast two different endoscopic assemblies. The handle assembly includesa housing, a trigger, a drive bar, a ratchet engagement assembly, and aratchet mechanism. The housing defines a body portion and a fixed handleportion extending from the body portion. The trigger is pivotablyconnected to the housing and movable relative to the fixed handleportion of the housing between an un-actuated position and an actuatedposition. The drive bar is slidably supported within the body portion ofthe housing and operably coupled to the trigger such that movement ofthe trigger from the un-actuated position towards the actuated positiontranslates the drive bar distally through the body portion of thehousing. The drive bar also includes a ratchet rack disposed thereon.The ratchet engagement assembly is disposed within the body portion ofthe housing and includes an inner sleeve selectively slidable between adistal position and a proximal position.

The ratchet mechanism is disposed within the body portion of the housingand includes a pin, a cam disc, and a pawl disc. The cam disc ispivotably supported on the pin and defines a first stop surface. Thepawl disc is pivotably supported on the pin adjacent the cam disc. Thepawl disc defines a ratchet pawl and is operably coupled to the camdisc.

The inner sleeve is configured to contact the first stop surface of thecam disc upon sliding of the inner sleeve from the distal position tothe proximal position. Upon contacting the first stop surface, the innersleeve urges the cam disc and the pawl disc to rotate about the pin froma non-ratcheting use orientation to a ratcheting use orientation. In thenon-ratcheting use orientation, the ratchet pawl is positioned toinhibit operable engagement thereof with the ratchet rack upon distaltranslation of the drive bar. In the ratcheting use orientation, theratchet pawl is positioned to operably engage the ratchet rack upondistal translation of the drive bar.

The ratchet engagement assembly may further include a collar fixedlydisposed within the body portion of the housing. In such configurations,the inner sleeve may be slidably disposed within the collar. The ratchetengagement assembly may additionally include a biasing memberinterdisposed between the collar and the inner sleeve and configured tobias the inner sleeve towards the distal position.

The ratchet engagement assembly may be configured such that, uponengagement of an endoscopic assembly of a first type within the bodyportion of the housing, the endoscopic assembly of the first type urgesthe inner sleeve to slide from the distal position to the proximalposition. Additionally or alternatively, the ratchet engagement assemblymay be configured such that, upon engagement of an endoscopic assemblyof a second type within the body portion of the housing, the innersleeve is maintained in the distal position.

The ratchet mechanism may further include a first biasing memberoperably coupling the cam disc and the pawl disc. The first biasingmember may be a torsion spring including a body pivotably disposed aboutthe pin, a first leg engaged with the cam disc, and a second leg engagedwith the pawl disc. Further, the torsion spring may be configured toenable the pawl disc to rotate together with the cam disc between thenon-ratcheting use orientation and the ratcheting use orientation, andto permit the pawl disc to rotate relative to the cam disc to operablyengage the ratchet rack upon distal translation of the drive bar. Theratchet mechanism may additionally or alternatively include a secondbiasing member configured to bias the cam disc and the pawl disc towardsthe non-ratcheting use orientation.

The cam disc may define a second stop surface that is configured to abuta shelf defined within the body portion of the housing to inhibitrotation of the cam disc beyond the ratcheting use orientation.

The handle assembly may further include a latch assembly operablysupported on the body portion of the housing. The latch assembly mayinclude a lever latch configured to releasably engage an endoscopicassembly inserted into the body portion of the housing.

The lever latch may include a distal engagement tooth configured toengage the endoscopic assembly inserted into the body portion of thehousing. Additionally or alternatively, the lever latch may include aproximal manipulation portion configured for manual manipulation todisengage the distal engagement tooth from the endoscopic assembly topermit removal of the endoscopic assembly from the body portion of thehousing.

Also provided in accordance with aspects of the present disclosure is asurgical clip applying system including a handle assembly and a firstendoscopic assembly. The handle assembly includes a housing, a triggeroperably associated with the housing and movable relative theretobetween an un-actuated position and an actuated position, a drive bar, asleeve slidably disposed within the housing, and a ratchet mechanism.The drive bar is slidably supported within the housing and operablycoupled to the trigger such that movement of the trigger from theun-actuated position towards the actuated position translates the drivebar through the housing. The drive bar further includes a ratchet rackdisposed thereon.

The ratchet mechanism is disposed within the housing and includes a camdisc defining a first stop surface and a pawl disc. The pawl discdefines a ratchet pawl and is operably coupled to the cam disc.

The first endoscopic assembly is configured for ratcheting use andincludes a first proximal hub insertable into and releasably engagablewithin the housing of the handle assembly. Upon such insertion, thefirst proximal hub urges the sleeve to contact the first stop surface ofthe cam disc and urge the cam disc and the pawl disc to rotate from anon-ratcheting use orientation, wherein the ratchet pawl is positionedto inhibit operable engagement thereof with the ratchet rack, and aratcheting use orientation, wherein the ratchet pawl is positioned tooperably engage the ratchet rack.

The clip applying system may further include a second endoscopicassembly configured for non-ratcheting use. The second endoscopicassembly may include a second proximal hub insertable into andreleasably engagable within the housing. Upon insertion of the secondproximal hub into the housing, the sleeve is maintained in its initialposition such that the cam disc and the pawl disc are maintained in thenon-ratcheting use orientation.

The first proximal hub of the first endoscopic assembly may include abody and a push-block extending proximally from the body. The push-blockis configured to urge the sleeve from a first position to a secondposition to thereby rotate the cam disc and the pawl disc from thenon-ratcheting use orientation to the ratcheting use orientation.

The second proximal hub of the second endoscopic assembly may be devoidof a push-block such that, upon insertion of the second proximal hubinto the housing, the sleeve is maintained in its initial position suchthat the cam disc and the pawl disc are maintained in the non-ratchetinguse orientation.

The ratchet mechanism may further include a torsion spring operablycoupling the cam disc and the pawl disc. More specifically, the torsionspring may include a body, a first leg engaged with the cam disc, and asecond leg engaged with the pawl disc. The torsion spring may further beconfigured to enable the pawl disc to rotate together with the cam discbetween the non-ratcheting use orientation and the ratcheting useorientation, and to permit the pawl disc to rotate relative to the camdisc to operably engage the ratchet rack upon distal translation of thedrive bar. The ratchet mechanism may additionally or alternativelyinclude a compression spring configured to bias the cam disc and thepawl disc towards the non-ratcheting use orientation.

The cam disc of the ratchet mechanism of the handle assembly may definea second stop surface configured to abut a shelf defined within thehousing to inhibit rotation of the cam disc beyond the ratcheting useorientation.

BRIEF DESCRIPTION OF THE DRAWINGS

Aspects and features of the presently-disclosed endoscopic surgical clipapplier are described in detail with reference to the drawing figureswherein like reference numerals identify similar or identical structuralelements and:

FIG. 1 is a side view of an endoscopic surgical clip applier provided inaccordance with the present disclosure including a handle assemblyhaving an endoscopic assembly engaged therewith;

FIG. 2A is side, longitudinal, cross-sectional view of the area ofdetail indicated in FIG. 1;

FIG. 2B is a front, perspective view of the area of detail indicated inFIG. 1;

FIG. 3A is a side, perspective view of the distal end of the endoscopicassembly of FIG. 1;

FIG. 3B is a side, longitudinal, cross-sectional view of a proximalportion of an outer shaft of the endoscopic assembly of FIG. 1;

FIG. 4A is a side, perspective view of a distal end of anotherendoscopic assembly configured for use with the endoscopic clip applierof FIG. 1;

FIG. 4B is a side, longitudinal, cross-sectional view of a proximalportion of an outer shaft of the endoscopic assembly of FIG. 4A;

FIG. 5 is a rear, perspective view of the handle assembly of FIG. 1,with a portion of the housing removed to illustrate the internalcomponents therein;

FIG. 6 is a side, longitudinal, cross-sectional view of the handleassembly of FIG. 1;

FIG. 7 is an enlarged, side, longitudinal, cross-sectional view of thearea of detail indicated as “7” in FIG. 6;

FIG. 8 is a side, longitudinal, cross-sectional view of the handleassembly of FIG. 1 including the endoscopic assembly of FIGS. 3A and 3Bengaged therein, wherein a trigger of the handle assembly is disposed inan un-actuated position;

FIG. 9 is an enlarged, side, longitudinal, cross-sectional view of thearea of detail indicated as “9” in FIG. 8;

FIG. 10 is a side, perspective view of a portion of the endoscopicsurgical clip applier of FIG. 1 illustrating the endoscopic assemblyengaged within the handle assembly with the handle assembly disposed ina ratcheting-use condition;

FIG. 11 is a side, longitudinal, cross-sectional view of the handleassembly of FIG. 1 including the endoscopic assembly of FIG. FIGS. 3Aand 3B engaged therein, wherein the trigger is disposed between theun-actuated position and an actuated position;

FIG. 12 is an enlarged, side, longitudinal, cross-sectional view of thearea of detail indicated as “12” in FIG. 11; and

FIG. 13 is an enlarged, side, longitudinal, cross-sectional view of theportion of the handle assembly of FIG. 1 including the endoscopicassembly of FIG. FIGS. 3A and 3B engaged therein as illustrated in FIG.12, wherein a drive assembly of the handle assembly is disposed in adistal-most position.

DETAILED DESCRIPTION

Turning to FIGS. 1, 2A, and 2B, an endoscopic surgical clip applierprovided in accordance with the present disclosure is identified byreference numeral 10. Surgical clip applier 10 generally includes ahandle assembly 100 and a plurality of endoscopic assemblies 200, 300(FIGS. 4A and 4B) selectively connectable to and extendable distallyfrom handle assembly 100. Handle assembly 100 is advantageouslyconfigured to operate each of endoscopic assemblies 200, 300 uponconnection thereto, and may be configured as a sterilizable, reusablecomponent such that handle assembly 100 may be repeatedly used withdifferent and/or additional endoscopic assemblies 200, 300 during thecourse of one or more surgical procedures. The endoscopic assemblies200, 300 may be configured as single-use disposable components,limited-use disposable components, or reusable components, dependingupon a particular purpose and/or the configuration of the particularendoscopic assembly. In either configuration, the need for multiplehandle assemblies 100 is obviated and, instead, the surgeon need onlyselect an appropriate endoscopic assembly 200, 300 and connect thatendoscopic assembly to handle assembly 100 in preparation for use.

With additional reference to FIGS. 3A-4B, handle assembly 100, morespecifically, is configured for both ratcheting use, e.g., in connectionwith endoscopic assembly 200 (FIGS. 1 and 2A-3B), and non-ratchetinguse, e.g., in connection with endoscopic assembly 300 (FIGS. 4A and 4B).Referring to FIGS. 1, 3A, and 3B, endoscopic assembly 200 is configuredfor ratcheting use and generally includes a proximal hub 220, anelongated shaft 240 extending distally from proximal hub 220, an endeffector assembly 260 disposed on a distal end portion of elongatedshaft 240, and an inner drive assembly (not shown) operably coupledbetween handle assembly 100 and end effector assembly 260 whenendoscopic assembly 200 is engaged with handle assembly 100 to enablethe sequential firing and forming of at least one surgical clip (notshown) about tissue. Proximal hub 220 includes a body 222 having anannular channel 224 defined therein on a proximal end portion thereofProximal hub 220 further includes a push-block or relatively longerextension 226 that extends proximally from body 222. These features ofproximal hub 220 are described in greater detail below. A more-detaileddescription of end effector assembly 260 and the inner drive assembly(not shown) of endoscopic assembly 200 are provided in InternationalApplication No. PCT/CN2015/091603, filed on Oct. 10, 2015, the entirecontent of which is hereby incorporated herein by reference. Further, itis contemplated that endoscopic assembly 200 may be configured to close,fire or form surgical clips similar to those shown and described in U.S.Pat. Nos. 7,819,886 or 7,905,890, the entire content of each of which isincorporated herein by reference.

Referring to FIGS. 4A-4B, endoscopic assembly 300 is configured fornon-ratcheting use and generally includes a proximal hub 320, anelongated shaft 340 extending distally from proximal hub 320, an endeffector assembly 360 disposed on a distal end portion of elongatedshaft 340, and an inner drive assembly (not shown) operably coupledbetween handle assembly 100 and end effector assembly 360 whenendoscopic assembly 300 is engaged with handle assembly 100 to enablegrasping and/or manipulation of tissue, retrieval of a surgical clip,and firing and forming the surgical clip about tissue. Proximal hub 320includes a body 322 having an annular channel 324 defined therein on aproximal end portion thereof Notably, and in contrast to proximal hub220 of endoscopic assembly 200 (FIG. 3B), body 322 of proximal hub 320defines the proximal-most portion of proximal hub 320; proximal hub 320does not include a push-block that extends proximally from body 322, or,alternatively, proximal hub 320 includes a push-block that is relativelyshorter as compared to push-block 226 of endoscopic assembly 200. Amore-detailed description of end effector assembly 360 and the innerdrive assembly (not shown) of endoscopic assembly 300 are also providedin International Application No. PCT/CN2015/091603, previouslyincorporated herein by reference. It is contemplated that endoscopicassembly 300 be configured to close, fire or form surgical clips similarto those shown and described in U.S. Pat. No. 4,834,096, the entirecontent of which is incorporated herein by reference.

Although exemplary endoscopic assemblies 200, 300 configured forratcheting and non-ratcheting use, respectively, are detailed above, itis contemplated that various other endoscopic assemblies for performingvarious different surgical tasks and/or having various differentconfigurations suitable for ratcheting or non-ratcheting use maylikewise be utilized with handle assembly 100. More specifically, it iscontemplated and within the scope of the present disclosure that otherendoscopic assemblies including a pair of jaws having a unique anddiverse closure stroke length thereof, may be provided for use withhandle assembly 100 for ratcheting use or non-ratcheting use, similarlyas detailed above with respect to endoscopic assemblies 200, 300. Such aconfiguration accommodates various different endoscopic assemblieshaving different configurations and/or different closure stroke lengthswhile providing a constant actuation stroke length of trigger 122 oftrigger assembly 120 of handle assembly 100. Accordingly, variousendoscopic assemblies, constructed in accordance with the principles ofthe present disclosure, may be provided which are also capable of firingor forming or closing surgical clips of various sizes, materials, andconfigurations, across multiple platforms for multiple differentmanufactures.

With reference to FIGS. 1, 2A, 2B, and 5, handle assembly 100 generallyincludes a housing 110, a trigger assembly 120 pivotably coupled tohousing 110, a drive assembly 130 operably coupled to trigger assembly120, a ratchet mechanism 140 selectively operably associated with driveassembly 130, a latch assembly 160 configured to releasably latch anendoscopic assembly 200, 300 (FIGS. 2-2B and 3A-3B, respectively) inengagement with handle assembly 100, a receiver tube 170 extendingdistally from housing 110 and configured to receive the proximal hub220, 320 of the endoscopic assembly 200, 300 (FIGS. 1-3B and 4A-4B,respectively) inserted into handle assembly 100, and a rotation knob 180disposed about receiver tube 170.

Handle assembly 100 is detailed below in connection with endoscopicassembly 200. Similarities in the engagement and use of handle assembly100 with a non-ratcheting endoscopic assembly, e.g., endoscopic assembly300 (FIGS. 3A and 3B), and with ratcheting endoscopic assembly 200 willnot be described in detail below for purposes of brevity. Differencestherebetween will be noted hereinbelow where applicable.

Housing 110 of handle assembly 100 defines a body portion 111 and afixed handle portion 112 extending downwardly from body portion 111.Housing 110 is formed from first and second housing components or halves113 a, 113 b secured to one another via a plurality of screws 114,although first and second housing components 113 a, 113 b mayalternatively be secured in any other suitable manner, e.g., ultrasonicwelding, gluing, other mechanical engagement, etc. Housing 110 isconfigured to house the internal working components of handle assembly100. Body portion 111 includes a distal nose 115 defining an annularslot 116 on the interior thereof. More specifically, first and secondhousing components 113 a, 113 b each define a semi-annular slot portionsuch that, when first and second housing components 113 a, 113 bcooperate to form housing 110, annular slot 116 is formed. Receiver tube170 of handle assembly 100 includes an annular rim 172 disposedthereabout on a proximal end portion thereof. Annular rim 172 iscaptured within annular slot 116 defined within distal nose 115 ofhousing 110, e.g., upon engagement of first and second housingcomponents 113 a, 113 b with one another. Annular rim 172 is capturedwithin annular slot 116 to rotatably engage receiver tube 170 withhousing 110. Rotation knob 180 of handle assembly 100 is engaged aboutreceiver tube 170, e.g., via a pair of opposed engagement pins 182, infixed rotational orientation relative thereto such that rotation ofrotation knob 180 relative to housing 110 effects similar rotation ofreceiver tube 170 relative to housing 110.

Body portion 111 of housing 110 further incudes an internal pivot post117 extending transversely between housing components 113 a, 113 b (fromeither or both of housing components 113 a, 113 b), as detailed below.Fixed handle portion 112 of housing 110 is configured to facilitategrasping of handle assembly 100 and manipulation thereof and ismonolithically formed with body portion 111, although otherconfigurations are also contemplated.

Referring to FIGS. 1, 5, and 6, trigger assembly 120 generally includesa trigger 122, a biasing member 127, and a linkage 128. Trigger 122includes a grasping portion 123, an intermediate pivot portion 124, anda proximal extension portion 125. Grasping portion 123 of trigger 122extends downwardly from body portion 111 of housing 110 in opposedrelation relative to fixed handle portion 112 of housing 110. Graspingportion 123 is configured to facilitate grasping and manipulation oftrigger 122. Intermediate pivot portion 124 of trigger 122 is at leastpartially disposed within housing 110 and is pivotably supported onpivot post 117 of housing 110 so as to enable pivoting of trigger 122about pivot post 117 and relative to housing 110, e.g., between anun-actuated position, wherein grasping portion 123 of trigger 122 isspaced-apart relative to fixed handle portion 112, and an actuatedposition, wherein grasping portion 123 of trigger 122 is approximatedrelative to fixed handle portion 112.

Proximal extension portion 125 of trigger 122 of trigger assembly 120 isdisposed on an opposite side of intermediate pivot portion 124 and,thus, pivot post 117, as compared to grasping portion 123 of trigger122. As such, pivoting of grasping portion 123 proximally, e.g., towardsthe actuated position, urges proximal extension portion 125 distally.Proximal extension portion 125 is pivotably coupled to the proximal endof linkage 128. Biasing member 127 is secured at either end and extendsbetween proximal extension portion 125 and a support disposed withinfixed handle portion 112 of housing 110. Pivoting of grasping portion123 towards the actuated position elongates biasing member 127 storingenergy therein such that, upon release of grasping portion 123, graspingportion 123 is returned towards the un-actuated position under the biasof biasing member 127. Although illustrated as an extension coil spring,biasing member 127 may define any suitable configuration for biasinggrasping portion 123 of trigger 122 towards the un-actuated position.

As noted above, linkage 128 is coupled at its proximal end to proximalextension portion 125 of trigger 122. Linkage 128 is also pivotablycoupled, at its distal end, to proximal extension 134, which extendsdistally from drive bar 132 of drive assembly 130. As a result of thisconfiguration, pivoting of grasping portion 123 of trigger 122 towardsthe actuated position urges proximal extension portion 125 of triggerdistally which, in turn, urges linkage 128 distally.

With additional reference to FIGS. 7 and 10, drive assembly 130 ofhandle assembly 100 includes drive bar 132, proximal extension 134, aratchet engagement assembly 136, and a ratchet rack 138. Drive bar 132extends in a generally longitudinal direction. As noted above, proximalextension 134 extends proximally from drive bar 132 and serves topivotably couple drive bar 132 with linkage 128. Ratchet engagementassembly 136 includes a distal collar 137 a that is fixedly mountedwithin body portion 111 of housing 110, an inner sleeve 137 b slidablydisposed within distal collar 137 a, and a biasing member 137 cpositioned within distal collar 137 a and configured to bias innersleeve 137 b distally relative to distal collar 137 a. Biasing member137 c may be configured as a coil compression spring, although otherconfigurations are also contemplated. Ratchet rack 138 extends in agenerally longitudinal direction, similar to drive bar 132, and isdefined on or engaged with drive bar 132 on an underside thereof Drivebar 132 defines proximal and distal recesses 133 a, 133 b, respectively,disposed adjacent the respective proximal and distal ends of drive bar132.

With reference to FIGS. 6-10, ratchet mechanism 140 of handle assembly100, as noted above, is selectively operably associated with driveassembly 130 to enable use of handle assembly 100 in either a ratchetingcondition or a non-ratcheting condition. Ratchet mechanism 140 includesa pin 142, a cam disc 144, a pawl disc 148, and first and second biasingmembers 152, 154. Pin 142 is engaged within body portion 111 of housing110 and extends transversely within body portion 111 of housing 110. Camdisc 144 is rotatably mounted about pin 142 and defines a cut-outforming first and second oppositely-facing stop surfaces 146 a, 146 b(FIG. 10) on cam disc 144, as detailed below.

Pawl disc 148 is rotatably mounted about pin 142 adjacent cam disc 144.Pawl disc 148 includes a ratchet pawl 149 extending therefrom that isconfigured to operably engage ratchet rack 138 of drive assembly 130 topermit incremental advancement of drive bar 132 through and relative tobody portion 111 of housing 110, as detailed below. Pawl disc 148 isrotatable, in connection with cam disc 144, between a non-ratcheting useorientation, wherein ratchet pawl 149 is inhibited from engaging ratchetrack 138 upon advancement of drive bar 132, and a ratcheting-useorientation, wherein ratchet pawl 149 is operably positioned toincrementally engage ratchet rack 138 upon distal advancement of drivebar 132.

With reference to FIG. 10, first biasing member 152 is configured as atorsion spring having a base 153 a and first and second legs 153 b, 153c extending from base 153 a. Base 153 a is rotatably mounted about pin142, first leg 153 b is engaged with cam disc 144, and second leg 153 cis engaged with pawl disc 148. As a result of this configuration, firstbiasing member 152 serves to operably couple cam disc 144 and pawl disc148 with one another. More specifically, first biasing member 152 biasespawl disc 148 to rotate together with cam disc 144 about pin 142 in theabsence of sufficient external influence to overcome the bias. Asdetailed below, this configuration enables rotation of pawl disc 148about pin 142 from the non-ratcheting use orientation to the ratchetinguse orientation in response to rotation of cam disc 144 upon engagementof an endoscopic assembly configured for ratcheting use, e.g.,endoscopic assembly 200 (FIGS. 3A and 3B), with handle assembly 100.However, the bias of first biasing member 152 may be overcome inresponse to application of sufficient external influence thereto, thuspermitting relative rotation between pawl disc 148 and cam disc 144. Asalso detailed below, this configuration enables rotation of pawl disc148 about pin 142 and relative to cam disc 144 during actuation toenable incremental engagement of ratchet pawl 149 with ratchet rack 138and to permit return of drive bar 132 after a complete actuation.

Second biasing member 154 of ratchet assembly 140 extends, e.g.,longitudinally, within body portion 111 of housing 110. The proximal endof second biasing member 154 is fixed within body portion 111 of housing110, while the distal end of second biasing member 154 is engaged withcam disc 144. The distal end of second biasing member 154 mayalternatively be engaged with pawl disc 148. Second biasing member 154is configured as an extension coil spring and, as such, biases cam disc144 and pawl disc 148 towards the non-ratcheting use condition ofratchet mechanism 140, wherein ratchet pawl 149 is oriented to enableengagement thereof with ratchet rack 138.

Referring to FIGS. 1, 5, 8, and 9, latch assembly 160 includes a latchlever 162, a pivot pin 164, and a biasing member 166. Latch lever 162 isat least partially disposed within a cut-out defined without housing 110of handle assembly 100 to enable manual manipulation thereof and definesa distal engagement section 163 a, an intermediate section 163 b, and aproximal manipulatable section 163 c. Distal engagement section 163 a oflatch lever 162 includes an engagement tooth 168 extending therefrom.Engagement tooth 168 is configured to engage an endoscopic assemblyinserted into handle assembly 100. With respect to endoscopic assembly200, for example, upon insertion of proximal hub 220 of endoscopicassembly 200 into handle assembly 100, engagement tooth 168 isconfigured for engagement within annular channel 224 of proximal hub 220to lock endoscopic assembly 200 in engagement within handle assembly100.

Pivot pin 164 of latch assembly 160 pivotably couples intermediatesection 163 b of lever latch 162 with housing 110 of handle assembly 100such that urging of proximal manipulation section 163 c of lever latch162 in a first direction, e.g., downwardly into housing 110, urgesdistal engagement section 163 a of lever latch 162 in a second, oppositedirection e.g., upwardly out of engagement with annular channel 224 ofproximal hub 220 endoscopic assembly 200. Biasing member 166 isconfigured as a torsion spring, although other configurations are alsocontemplated, and is positioned to bias proximal manipulation section163 c of lever latch 162 upwardly, thereby biasing distal engagementsection 163 a downwardly towards an engaged position. Proximalmanipulation section 163 c of lever latch 162 is selectivelydepressible, against the bias of biasing member 166, to urge distalengagement section 163 a upwardly towards a disengaged position.

Referring to FIGS. 5-10, insertion and engagement of endoscopic assembly200 within handle assembly 100 (FIG. 1) is detailed. Initially, prior toinsertion of endoscopic assembly 200, as illustrated in FIGS. 6 and 7,trigger 122 is disposed in the un-actuated position under the bias ofbiasing member 127, drive bar 132 is disposed in a proximal-mostposition, and cam disc 144 and pawl disc 148 are oriented in thenon-ratcheting use orientation under the bias of second biasing member154. Further, at this point, and lever latch 162 is disposed in theengaged position under the bias of biasing member 166.

In order to engage endoscopic assembly 200 within handle assembly 100,as illustrated in FIGS. 8-10, proximal hub 220 of endoscopic assembly200 is inserted into rotation knob 180 of handle assembly 100 and slidproximally through rotation knob 180, receiver tube 170, and intohousing 110. As proximal hub 220 initially enters housing 110, proximalhub 220 receives the distal end of drive bar 132 of drive assembly 130.Further, push-block 226 of proximal hub 220 enters distal collar 137 aof drive assembly 130 and abuts the distal end of inner sleeve 137 b ofdrive assembly 130.

Upon further insertion of proximal hub 220 into housing 110 and distalcollar 137 a, push-block 226 of proximal hub 220 urges sleeve 137 bproximally against the bias of biasing member 137 c. As sleeve 137 b isurged proximally, the proximal end of sleeve 137 b is urged into contactwith first stop surface 146 a of cam disc 144 of ratchet assembly 140 tourge cam disc 144 to rotate in a counter-clockwise direction, accordingto the orientation of FIGS. 7 and 9, from the non-ratcheting useorientation (FIG. 7) to the ratcheting use orientation (FIG. 9). Morespecifically, cam disc 144 is rotated until second stop surface 146 bcontacts shelf 119 defined within body portion 111 of housing 110. Theabutment of second stop surface 146 b with shelf 119 inhibits furtherrotation of cam disc 144 and, thus, further proximal insertion ofproximal hub 220 of endoscopic assembly 200 into handle assembly 100.Due to the operable coupling of pawl disc 148 with cam disc 144 viafirst biasing member 152, as detailed above, rotation of cam disc 144urges pawl disc 148 to rotate from the non-ratcheting use orientation(FIG. 7) to the ratcheting use orientation (FIG. 9) such that ratchetpawl 149 is operably positioned to engage ratchet rack 138 of driveassembly 130 upon distal advancement of drive bar 132.

Simultaneously or in close temporal relation with the rotation of camdisc 144 and pawl disc 148 to the ratcheting use orientation in responseto further insertion of proximal hub 220 into housing 110, engagementtooth 168 of latch assembly 160 is cammed over the proximal end ofproximal hub 220 and into engagement within annular channel 224 ofproximal hub 220 to lock endoscopic assembly 200 in engagement withinhandle assembly 100.

Referring to FIGS. 3B, 4B, 7, and 9, as noted above, push-block 226 ofproximal hub 220 of endoscopic assembly 200 urges sleeve 137 bproximally to thereby rotate cam disc 144 and pawl disc 148 to theratcheting use orientation (FIG. 9). In embodiments where the endoscopicassembly, utilized with handle assembly 100, is configured fornon-ratcheting use, e.g., as with endoscopic assembly 300, since theendoscopic assembly is devoid of a push-block, cam disc 144 and pawldisc 148 remain disposed in the non-ratcheting use orientation (FIG. 7)under the bias of second biasing member 154 upon engagement of thenon-ratcheting endoscopic assembly with handle assembly 100.Non-ratcheting endoscopic assemblies such as endoscopic assembly 300 arereleasably locked in engagement within handle assembly 100 via latchassembly 160, similarly as detailed above with respect to the engagementof endoscopic assembly 200 within handle assembly 100.

Referring to FIGS. 8, 9, and 11-13, in use, with endoscopic assembly 200engaged within handle assembly 100, as detailed above, pawl disc 148 isdisposed in the ratcheting use orientation. Initially, trigger 122 isdisposed in the un-actuated position and, as such, ratchet pawl 149extends at least partially into distal recess 133 b of drive bar 132. Inorder to fire surgical clip applier 10 (FIG. 1), grasping portion 123 oftrigger 122 is pivoted towards fixed handle portion 112 of housing 110to urge linkage 128 distally which, in turn, urges drive bar 132distally through housing 110 and proximal hub 220 to drive the innerdrive assembly (not shown) of endoscopic assembly 200 distally.

As drive bar 132 is translated distally, as shown in FIGS. 11 and 12,ratchet pawl 149 incrementally engages ratchet rack 138, inhibitingproximal return of drive bar 132. Pawl disc 148 is permitted tooscillate relative to cam disc 144, thus permitting ratchet pawl 149 toincrementally engage the teeth of ratchet rack 138 as drive bar 132 isadvanced distally. This oscillatory movement of pawl disc 148 ispermitted due to the operable coupling of pawl disc 148 and cam disc 144via first biasing member 152, as detailed above.

With ratchet pawl 149 engaged with ratchet rack 138, drive bar 132 isinhibited from returning proximally and, thus, trigger 122 is inhibitedfrom returning towards the un-actuated position until a full actuationof trigger 122 has been completed and ratchet pawl 149 has clearedratchet rack 138 and entered proximal recess 133 a of drive bar 132(FIG. 13). During actuation, distal translation of drive bar 132 drivesthe inner drive assembly (not shown) of endoscopic assembly 200 to fireand form a surgical clip (not shown) from end effector assembly 360(FIG. 3A) about tissue. Ratchet mechanism 140, in the ratcheting usecondition, enables incremental firing of endoscopic assembly 200, asdetailed above.

Upon full actuation of trigger 122, e.g., upon reaching the actuatedposition of trigger 122, ratchet pawl 149 clears ratchet rack 138 andenters proximal recess 133 a of drive bar 132. Once ratchet pawl 149 hascleared ratchet rack 138, trigger 122 may be released and returned tothe un-actuated position under the bias of biasing member 127, therebyreturning drive bar 132 proximally. As drive bar 132 is returnedproximally ratchet pawl 149 cams over the ratchet teeth of ratchet rack138 without engaging the ratchet teeth. Thus, free return of drive bar132 to its proximal-most position may be achieved. Upon return oftrigger 122 to the un-actuated position, the above-detailed use ofsurgical clip applier 10 may be repeated to fire and form additionalsurgical clips (not shown).

Referring momentarily to FIGS. 1 and 4A-5, the use of endoscopicassembly 300 with handle assembly 100 is similar to that detailed abovewith respect to endoscopic assembly 200 except that, with pawl disc 148maintained in the non-ratcheting use orientation (due to non-ratchetingendoscopic assemblies not including a push-block), ratchet pawl 149 isinhibited from engaging ratchet rack 138. Accordingly, during use ofendoscopic assembly 300, trigger 122 may be freely pivoted between theun-actuated and actuated positions, and may be returned towards theun-actuated at any point during the actuation stroke.

Turning back to FIGS. 6-9, in order to disengage endoscopic assembly 200from handle assembly 10, e.g., for cleaning and/or sterilization, or toreplace endoscopic assembly 200 with another endoscopic assembly,proximal manipulation section 163 c of lever latch 162 of latch assembly160 is depressed inwardly into housing 110, against the bias of biasingmember 166, to urge distal engagement section 163 a of lever latch 162upwardly and out of engagement within annular channel 224 of proximalhub 220 of endoscopic assembly 200. With distal engagement section 163 aof lever latch 162 disposed in this disengaged position, proximal hub220 of endoscopic assembly 200 may be withdrawn distally from handleassembly 100. Upon withdrawal of endoscopic assembly 200 from handleassembly 100, cam disc 144 and pawl disc 148 of ratchet mechanism 140are returned to the non-ratcheting use orientation under the bias ofsecond biasing member 154.

In accordance with the present disclosure, it is contemplated that asurgical system or kit (not shown) may be provided which includes ahandle assembly 100, at least one endoscopic assembly 200, at least oneendoscopic assembly 300, and instructions for using the same. It isfurther contemplated that a plurality of handle assemblies may beprovided in the surgical system or kit. It is additionally contemplatedthat the surgical system or kit may include additional endoscopicassemblies, not shown or described herein, which are different fromendoscopic assemblies 200 or 300, and which are configured to connectionto and operation by handle assembly 100. It is still furthercontemplated that the surgical system or kit may include at least onecartridge of surgical clips or fasteners (not shown) for use with any ofthe endoscopic assemblies disclosed herein.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. A handle assembly of a surgical clip applierconfigured to releasably engage at least two different endoscopicassemblies, the handle assembly comprising: a housing defining a bodyportion and a fixed handle portion extending from the body portion; atrigger pivotably connected to the housing and movable relative to thefixed handle portion between an un-actuated position and an actuatedposition; a drive bar slidably supported within the body portion of thehousing and operably coupled to the trigger such that movement of thetrigger from the un-actuated position towards the actuated positiontranslates the drive bar distally through the body portion of thehousing, the drive bar including a ratchet rack disposed thereon; aratchet engagement assembly disposed within the body portion of thehousing and including an inner sleeve selectively slidable between adistal position and a proximal position; and a ratchet mechanismdisposed within the body portion of the housing, the ratchet mechanismincluding: a pin; a cam disc pivotably supported on the pin, the camdisc defining a first stop surface; and a pawl disc pivotably supportedon the pin adjacent the cam disc, the pawl disc defining a ratchet pawland being operably coupled to the cam disc, wherein, the inner sleeve isconfigured to contact the first stop surface of the cam disc uponsliding of the inner sleeve from the distal position to the proximalposition and urge the cam disc and the pawl disc to rotate about the pinfrom a non-ratcheting use orientation to a ratcheting use orientation,wherein: in the non-ratcheting use orientation, the ratchet pawl ispositioned to inhibit operable engagement thereof with the ratchet rackupon distal translation of the drive bar; and in the ratcheting useorientation, the ratchet pawl is positioned to operably engage theratchet rack upon distal translation of the drive bar.
 2. The handleassembly according to claim 1, wherein the ratchet engagement assemblyfurther includes a collar fixedly disposed within the body portion ofthe housing, and wherein the inner sleeve is slidably disposed withinthe collar.
 3. The handle assembly according to claim 2, wherein theratchet engagement assembly further includes a biasing memberinterdisposed between the collar and the inner sleeve and configured tobias the inner sleeve towards the distal position.
 4. The handleassembly according to claim 1, wherein the ratchet engagement assemblyis configured such that, upon engagement of an endoscopic assembly of afirst type within the body portion of the housing, the endoscopicassembly of the first type urges the inner sleeve to slide from thedistal position to the proximal position.
 5. The handle assemblyaccording to claim 4, wherein the ratchet engagement assembly is furtherconfigured such that, upon engagement of an endoscopic assembly of asecond type within the body portion of the housing, the inner sleeve ismaintained in the distal position.
 6. The handle assembly according toclaim 1, wherein the ratchet mechanism further includes a first biasingmember operably coupling the cam disc and the pawl disc.
 7. The handleassembly according to claim 6, wherein the first biasing member is atorsion spring including a body pivotably disposed about the pin, afirst leg engaged with the cam disc, and a second leg engaged with thepawl disc.
 8. The handle assembly according to claim 7, wherein thetorsion spring is configured to enable the pawl disc to rotate togetherwith the cam disc between the non-ratcheting use orientation and theratcheting use orientation, and to permit the pawl disc to rotaterelative to the cam disc to operably engage the ratchet rack upon distaltranslation of the drive bar.
 9. The handle assembly according to claim1, wherein the cam disc defines a second stop surface, the second stopsurface configured to abut a shelf defined within the body portion ofthe housing to inhibit rotation of the cam disc beyond the ratchetinguse orientation.
 10. The handle assembly according to claim 1, furthercomprising a latch assembly operably supported on the body portion ofthe housing, the latch assembly including a lever latch configured toreleasably engage an endoscopic assembly inserted into the body portionof the housing.
 11. The handle assembly according to claim 10, whereinthe lever latch includes a distal engagement tooth configured to engagethe endoscopic assembly inserted into the body portion of the housing.12. The handle assembly according to claim 11, wherein the lever latchincludes a proximal manipulation portion configured for manualmanipulation to disengage the distal engagement tooth from theendoscopic assembly to permit removal of the endoscopic assembly fromthe body portion of the housing.
 13. A surgical clip applying system,comprising: a handle assembly, including: a housing; a trigger operablyassociated with the housing and movable relative thereto between anun-actuated position and an actuated position; a drive bar slidablysupported within the housing and operably coupled to the trigger suchthat movement of the trigger from the un-actuated position towards theactuated position translates the drive bar through the housing, thedrive bar including a ratchet rack disposed thereon; a sleeve slidablydisposed within the housing; and a ratchet mechanism disposed within thehousing, the ratchet mechanism including a cam disc defining a firststop surface and a pawl disc defining a ratchet pawl and being operablycoupled to the cam disc; and a first endoscopic assembly configured forratcheting use, the first endoscopic assembly including a first proximalhub insertable into and releasably engagable within the housing,wherein, upon insertion of the first proximal hub into the housing, thefirst proximal hub urges the sleeve to contact the first stop surface ofthe cam disc and urge the cam disc and the pawl disc to rotate from anon-ratcheting use orientation, wherein the ratchet pawl is positionedto inhibit operable engagement thereof with the ratchet rack, and aratcheting use orientation, wherein the ratchet pawl is positioned tooperably engage the ratchet rack.
 14. The clip applying system accordingto claim 13, further comprising: a second endoscopic assembly configuredfor non-ratcheting use, the second endoscopic assembly including asecond proximal hub insertable into and releasably engagable within thehousing, wherein, upon insertion of the second proximal hub into thehousing, the sleeve is maintained in its initial position such that thecam disc and the pawl disc are maintained in the non-ratcheting useorientation.
 15. The clip applying system according to claim 13, whereinthe first proximal hub includes a body and a push-block extendingproximally from the body, the push-block configured to urge the sleevefrom a first position to a second position to thereby rotate the camdisc and the pawl disc from the non-ratcheting use orientation to theratcheting use orientation.
 16. The clip applying system according toclaim 15, wherein the second proximal hub is devoid of a push-block suchthat, upon insertion of the second proximal hub into the housing, thesleeve is maintained in its initial position such that the cam disc andthe pawl disc are maintained in the non-ratcheting use orientation. 17.The clip applying system according to claim 13, wherein the ratchetmechanism further includes a torsion spring operably coupling the camdisc and the pawl disc, the torsion spring including a body, a first legengaged with the cam disc, and a second leg engaged with the pawl disc.18. The clip applying system according to claim 17, wherein the torsionspring is configured to enable the pawl disc to rotate together with thecam disc between the non-ratcheting use orientation and the ratchetinguse orientation, and to permit the pawl disc to rotate relative to thecam disc to operably engage the ratchet rack upon distal translation ofthe drive bar.
 19. The clip applying system according to claim 13,wherein the cam disc defines a second stop surface, the second stopsurface configured to abut a shelf defined within the housing to inhibitrotation of the cam disc beyond the ratcheting use orientation.